ph.d psychologist vs. m.d. psychiatrist

i would like for anyone to offer feedback regarding the two professions. i’m already familiar with the major differences regarding prescribing meds, counseling vs. medical care, etc.

i’m wondering about income level differences, credibility differences, schedule differences, etc. i would also like to know what some employment options are for a psychiatrist other than treating schizophrenics and bipolars.

i’ve read so many positive things about psychiatrists, as well as negatives. someone said the other day that psychiatrists are the “laughing stocks” of the medical profession. i thought that was very sad, given all the training, equal education, and seriousness with which most psychiatrists practice.

any feedback is appreciated…i’m asking because my undergrad is psychology (always intended to become a psychiatrist) and so many people are working to convince me to the path of psychology.

ALSO, is it true that getting through medical school does NOT guarantee that one can get a residency that is in the field in which they seek to practice?

  • shegigi Said:
ALSO, is it true that getting through medical school does NOT guarantee that one can get a residency that is in the field in which they seek to practice?

Nothing in life is guaranteed...from everything I've read and from talking to people including physicians, it all depends on your grades, how you interview, etc.
  1. I believe that psychiatry is a less competitive residency than average. Copious amounts of public data is release each year for residency matching and this could be easily researched

  2. Joe Wright, an active OPM member and NPR commentator before Harvard Medical School got too busy for him, had an excellent post on this in late 2006, linked below

    Link: JoeWright Psychology Psychiatry comments

Rich is correct that psychiatry is less competitive than other residency programs. Of course, as with any specialty, the relative competitiveness varies by residency program. While the overall match is less competitive, there are programs which are more competitive and require very good grades and scores.

The question remains what do actually want to do as it generally perceived that the classic psychiatrist providing therapy barely exists anymore. If you are looking to do that then clinical psych maybe a better route. On the note, it appears that clinical social work is the fastest growing profession in this area. I also have to mention money on this topic. There is an insidious behavior by medical insurance companies who say they cover mental health issues but then limit the number of approved providers in their network. these providers often are so booked that new patients can’t get in. Thus the payout of these mental health benefits is limited

THe way I understand getting a residency, it does depend alot on your grades and Step score. However, my mentor a MD/PHD said there was a 6000 slot shortage this year across the whole US. Only 18000 students were in the pool. So, the question is where you get the residency. You may or may not get it in a preferred location…Is the way I understand it…

Residency does depends on grades, STEP scores, & recommendations. While the US graduates approx 18000 MD/DO students per year, there are 26000 PGY-1 slots per year. This approximately 8000 residents come from foreign medical schools. Residency slots, however, are not equally divided nor equally competitive. So you will have few slots for neurosurgery and multiple applicants per slot. The most competitive seem to be as Dr. Judy McElhiney explained at the 2009 conference is on the ROADE to happiness… Radiology, Ophthalmology, Anesthesiology, Dermatology, and Ear/Nose/Throat (I think).

The primary care specialties such as Family Practice, Internal Medicine, Pediatrics, OB/GYN, seem the least competitive. Psych is perhaps just a bit above these. BTW, my impression of why this is, relates directly to your initial question. A significant number of students who a generation or two would have gone MD-Psych are now going PhD/MSW route due to time, cost, &competitiveness

Sum, if you have decent STEP I, good grades, especially in psych rotations, and good recommendations from those rotations, getting a psych residency should be quite feasible

My other question still remains, what would like to be doing in practice?

Hi Sheila,

I have my bachelor’s in psychology also. I switched from that path to pre-med so I can do psychiatry. For me there were two primary reasons. The first is that I found that physiology and psychology are inseparable and I knew that I would not receive the level of biological training and knowledge (and more complete ability to help) that I crave. The other was that I tend to want “hard science.” Psychology just did not provide what I wanted. It will for some though (especially some of the programs with a more cognitive-behavioral and evidence-based orientation).

There are a lot of different paths just within psychology. Here in Florida there are three different types of master’s level practitioners with a lot of overlap.

Keep in mind also that many states require that licensure as a “psychologist” requires that you not only have a PhD or PsyD, but also that it is from an APA-accredited program. This makes a HUGE cost difference. I did extensive research before making the switch to premed and found that there are no private, APA-accredited programs in Florida that are less than 100K - 150K to finish. State schools are cheaper, but admission is pretty nearly as competitive as med school.

The American Psychological Association publishes extensive income information for both master’s and PhD/PsyD level practitioners on their website. Various web sources indicate psychiatry salaries are higher. However, there is an extreme spread, so the average may or may not be useful.

As far as credibility between the two, there’s probably no difference to the layperson. Few seem to know the difference between a psychiatrist and psychologist. At the professional level, I don’t know what the credibility difference is. The American Psychiatric Association publishes a free PDF about how to survive psychiatry residency. It starts off with a defensive position about how psychiatrists are doctors too, so there probably is a real difference in credibility between psychiatrists and other physicians.

I have seen that there are unfilled psychiatry residency slots every year, but when I went to look it up just now, I couldn’t find any figures.

The last thing I wanted to mention is that I do worry a lot about what I will be able to do when I finish. I want to be able to do a little more than just manage meds, especially to reach the homeless and people who normally can’t or won’t seek treatment. There are 3 problems I see that you will need to address. 1) You must be willing to reduce your own income. 2) You must be in a practice or with an employer where you can be fair to your colleagues or employers when you take extra time. 3) You must decide if the shortage of psychiatrists makes it incumbent upon you to try to treat as many as possible and let the other treatment team members do the therapy.

Sorry that’s so long.